Official Title
Low-flow Extracorporeal Carbon Dioxide Removal Using a Renal Replacement Therapy Platform for Correction of Hypercapnia in COVID-19-associated Acute Respiratory Distress Syndrome
Brief Summary

The study aims to investigate the efficacy of extracorporeal CO2 removal for correction of hypercapnia in coronavirus disease 19 (COVID-19)-associated acute respiratory distress syndrome

Detailed Description

The prevalence of acute respiratory distress syndrome (ARDS) caused by COVID-19 is approximately 8%. Lung-protective ventilation is the current standard of care for ARDS. It limits lung and distal organ impairment, but is associated with hypercapnia in approximately 14% of patients with mild to moderate ARDS and almost all patients with severe ARDS. In this setting, early implementing of an extracorporeal CO2 removal (ECCO2R) therapy may prevent further escalation of invasiveness of therapy (eg, need for extracorporeal membrane oxygenation (ECMO)). A number of low-flow ECCO2R devices are now available and some of those can be integrated into a renal replacement therapy (RRT) platform. This study aims to investigate the efficacy of an original ECCO2R system used in conjunction with a RRT platform in hypercapnic patients with COVID-19-associated mild-to-moderate ARDS with or without acute kidney injury (AKI) necessitating RRT.

Hypercapnic Respiratory Failure

Device: ECCO2R
ECCO2R integrated into the multiFiltrate device

Eligibility Criteria

Inclusion Criteria:

- mild-to-moderate ARDS according to the Berlin definition

- lung-protective ventilation with positive end-expiratory pressure (PEEP) > 5 cm of water on mechanical ventilation expected to last > 24 h

- hypercapnia 80 mmHg

- acute brain injury

- severe liver insufficiency (Child-Pugh scores > 7) or fulminant hepatic failure

- decision to limit therapeutic interventions

- catheter access to femoral vein or jugular vein impossible

- pneumothorax

Eligibility Gender
Eligibility Age
Minimum: 18 Years

Faeq Husain-Syed, MD

Istvan Vadasz, MD

Werner Seeger, MD
Study Director
University Hospital Giessen and Marburg, Giessen

University of Giessen
NCT Number
MeSH Terms
Respiratory Distress Syndrome, Newborn
Respiratory Distress Syndrome, Adult
Respiratory Insufficiency
Acute Lung Injury